SUSAN CAROL BRACK Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020001697

License Status

NOT RENEWED

Business

First Name

SUSAN CAROL

Last Name

BRACK

Business Name

SUSAN CAROL BRACK

Original Issue Date

07/13/1972

Effective Date

07/13/1972

Expiration Date

09/30/1984

City

GLENVIEW

State

Zip

60025

County

COOK

Ever Disciplined

LastModifiedDate

10/12/2005